As we described in the Methods section, our guideline on cardiac screening explicitly excluded preparticipation evaluation of athletes. Thus, the articles on screening of athletes that Dr. Zimmermann cited are not relevant. To clarify, Rubenstein and Greenfield (1) found that, in patients with chest pain who present to the emergency department, 5% (11 of 236) might have avoided an admission if a baseline ECG had been available. However, this percentage is a maximal estimate, because 9 of the 11 patients did not have a baseline ECG. In addition, how many admissions would have actually been avoided is unknown. Further, the authors found no cases in which an inappropriate discharge was avoided because a baseline ECG was available.